Provider Demographics
NPI:1245535681
Name:MAHER, DONNA (MS, RD, CDN, CDE)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:MS, RD, CDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9408 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7301
Mailing Address - Country:US
Mailing Address - Phone:718-238-5143
Mailing Address - Fax:718-491-4187
Practice Address - Street 1:9408 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7301
Practice Address - Country:US
Practice Address - Phone:718-238-5143
Practice Address - Fax:718-491-4187
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-16
Last Update Date:2011-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000896133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered